直肠癌患者术后放疗期间营养状态与机体组成成分的相关性分析

Correlation analysis of nutritional status and body composition in rectal cancer during postoperative radiotherapy

目的动态监测直肠癌患者术后放疗期间机体成分变化情况,分析其与患者营养不良状态的相关性,为术后放疗提供营养支持指导。方法入组60例直肠癌术后放疗患者,动态测定其放疗期间机体成分,包括机体总水量,蛋白质含量、矿物质含量、脂肪含量,骨骼肌含量。记录直肠癌患者放疗期间体质量指数(body mass index,BMI)与营养风险筛查量表(nutritional risk screening scale,NRS)2002评分,分析其与机体各组分变化的相关性。结果直肠癌患者术后放疗期间机体总含水量,蛋白质、脂肪含量,骨骼肌含量均逐渐下降(P<0.05),其中以机体骨骼肌含量与BMI和NRS2002评分的相关性最明显(r>0.9,P<0.001;r值为-0.769~-0.621,P<0.05),矿物质与机体BMI和NRS2002评分的相关性最差(r值为0.416~0.510,P<0.05;r值为-0.336~-0.198,P<0.05)。结论直肠癌患者术后放疗过程中的营养不良状态与机体骨骼肌含量下降关系密切,建议加强直肠癌术后患者放疗期间的营养支持管理,尤其是针对增加骨骼肌含量的营养管理。

Objective To dynamically detect the changes of body composition in patients with rectal cancer during radiotherapy,and to analyze the correlation between the decline of body composition and malnutrition status,so as to provide nutritional support guidance for rectal cancer patients during radiotherapy after operation.Methods Sixty patients with rectal cancer underwent radiotherapy after operation were enrolled.Total body water,protein,minerals,body fat mass,and skeletal muscle mass were detected dynamically.The correlation of the body composition with body mass index(BMI)and nutritional risk screening(NRS)2002 score was analyzed.Results The total water,protein,body fat,and skeletal muscle contents of patients declined gradually during radiotherapy(P<0.05).The skeletal muscle content was most significantly correlated with BMI and NRS2002 score(r>0.9,P<0.001;r=-0.769--0.621,P<0.05),and minerals content was least correlated with BMI and NRS2002 score(r=0.416-0.510,P<0.05;r=-0.336--0.198,P<0.05).Conclusion The nutritional status of patients with rectal cancer during radiotherapy after operation has the greatest relationship with the decrease of skeletal muscle content,and it is suggested to strengthen the nutritional support management of postoperative rectal cancer patients during radiotherapy,especially for increasing the content of skeletal muscle.